Beaumont Hospital APBI Fat Necrosis

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Fig. 17.2 The incidence of fat necrosis as a function of time after interstitial brachytherapy APBI at the William Beaumont Hospital (data plotted from Benitez et al. 2004)

Duration of Follow-up

Fig. 17.2 The incidence of fat necrosis as a function of time after interstitial brachytherapy APBI at the William Beaumont Hospital (data plotted from Benitez et al. 2004)

can be for both the better and the worse. Some end-point measures significantly improved with time. For example, the cosmetic rating was scored as excellent/good in 95% at a median follow-up of <6 months but improved to 99% after 60 months. Breast pain, present in 27% at <6 months, decreased to 9% at >5 years. Similarly, edema and erythema progressively improved over the observation period (Fig. 17.1). In contrast, other measured end-points clearly worsened with prolonged follow-up. Over time, the incidence of fat necrosis, subcutaneous fibrosis, and telangiectasias all progressively increased (Figs. 17.1-17.4). Of particular note, the incidence of fat necrosis rose from 0.5% at <6 months to 11% at >5 years (Fig. 17.2). These findings underscore the complexity inherent in the assessment of late normal-tissue effects after APBI as the incidence of any given endpoint will be highly dependent upon when the measurement was obtained. As such, all short follow-up, "snap-shot" views of normal tissue effects, as is the norm in most studies of APBI reported to date, must be interpreted with caution.

Breast Brachytherapy

Fig. 17.3 Grade 1 late skin toxicity after intersti- Fig. 17.4 Grade 3 late subcutaneous toxicity after tial brachytherapy APBI. Note the telangiectasias interstitial brachytherapy APBI. Note the fibrotic at the catheter entry sites in the lateral aspect of contracture of tissues within the implant volume the breast

Fig. 17.3 Grade 1 late skin toxicity after intersti- Fig. 17.4 Grade 3 late subcutaneous toxicity after tial brachytherapy APBI. Note the telangiectasias interstitial brachytherapy APBI. Note the fibrotic at the catheter entry sites in the lateral aspect of contracture of tissues within the implant volume the breast

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  • SABRINA
    How long before fat necrosis?
    11 months ago

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